RESULTS
Of the nine participating children (Figure
1), five had chronic diseases; four were
aged 4 to 6 years and five were aged 7 to 8
years. None of the children had previously
participated in TP sessions, according to their
companions.
Regarding the children’s companions, all
were female (eight mothers and an aunt), literate,
and aged between 21 and 39 years. None
was aware of the existence and applicability
of TP during hospitalization.
The data analysis allowed the construction
of two thematic categories: The
reactions and behaviours of children using
IV medication and TP, which were subdivided
into the following subcategories: I – before
the TP session, II - during the TP session, and
III- after the TP session; and the companions’
perceptions regarding TP.
Reactions and behaviours of children using
IV medication and TP
I - Before the TP session
The most frequent reaction observed
in children upon learning of an upcoming IV
drug administration was anxiety, expressed in looks and gestures of concern, especially
among the children aged between 4 and 6
years old:
The child said “no”, with characteristics
of tantrum, when noticing the
presence of the nurse responsible for
administering the medication; hides
the arm that had the access to the
medication. Closed the eyes when
the nurse connected the syringe to
the device to administer the medication
(C7, O1, 4 years old).
[...] he usually just keeps looking,
asks if it is going to hurt [...] closes his
eyes, waiting for pain. I also noticed
that today (I7, 4 years old).
The children in this age range were strongly
opposed to receiving the medication after
they became being aware of the procedure,
reacting negatively in an effort to prevent its
administration:
The child made it difficult to perform
the procedure, hiding the arm
behind the body. The medication was
only administered after the companion
put the child in her lap (C5, O1,
5 years old).
When the nurse arrives, she gets very
upset. Does not want to receive medication
and sometimes tries to pull
the syringe from the nurse’s hand (I5,
5 years old).
The child made it difficult to administer
the medication. She tried to
disconnect the drug administration
device (C9, O1, 6 years old).
[...] the situation is very stressful, not
only for her but for me and even for
the nurse [...] she cries, screams [...]
I sometimes lose my patience and
say that if she doesn’t stop crying,
I will slap her or she will not get to
play with the toys I brought (I9, 6
years old).
None of the children between 7 and 8
years old had difficulty accepting the procedure,
although some expressed anxiety about
when it would end:
The child was quiet, calm. She
accepted the medication without
difficulty and calmly stated when the
procedure began to bother her (C8,
O1, 8 years old).
Her behaviour today was the same
as always [...]. Of course she doesn’t
like it, but doesn’t give us a hard time.
She stays quiet, does not make a fuss.
If it hurts or bothers her in any way,
she says so (I8, 8 years old).
The child showed no difficulty and
remained calm during the drug administration,
but demonstrated anxiety
for it to end because she wanted to
return to her drawing activities (C3,
O1, years old).
Her behaviour was the same as every
day since she began receiving intravenous
medication. I know that she
doesn’t like being hospitalized and
need to be medicated, but she stays
very quiet, does not make a fuss or
cry [...]. She does not complain and is
already at an age where she unders tands that the medication will help her
get well and go home (I3, 8 years old).
A child from the study was hospitalized
during both those age ranges, and the companion
compared those hospitalizations:
His behaviour was normal [...]. He
already understands that he needs
the medication to get better and go
home, so his behaviour was good;
he was quiet. [...] He has already needed
other hospitalizations, and only
when he was younger did he give a
bit of trouble because he didn’t want
to stay quiet and thought something
was going to hurt. Over time, [...] he
ended up getting used to the medications
(I6, 7 years old).
II - During the TP session
Some of the 7- to 8-year-old children
initially showed shyness but became excited
when they were allowed to handle the materials
to simulate the procedures with the doll.
The child was shy at the beginning of
the TP session; however, as the story
began to be told, he became more
comfortable participating in the development
of the story; he assigned
the toy the symptoms that led him to
be hospitalized and simulated the venipuncture
and drug administration
procedures, explaining them step
by step. The character that the child
created did not like the venipuncture
because it was painful and received
the medication well because he
wanted to leave the hospital (C2, O2,
8 years old).
During the play, initially, he was embarrassed
[...] but later got excited
[...]. The story about the doll becoming
sick and needing to be hospitalized,